Ringlike peripheral high iodine concentration can differentiate lung cancer from pulmonary metastases: AJR

Japan: Ringlike peripheral high iodine concentration could help guide management in patients with known cancer and an indeterminate solitary nodule, a recent study in the American Journal of Roentgenology (AJR) has shown.

In the accepted manuscript, the researchers found that ringlike peripheral high iodine concentration showed high specificity (albeit poor sensitivity), an excellent interobserver agreement, for differentiating pulmonary metastasis from primary lung cancer and independently predicted pulmonary metastasis.

In the AJR-accepted manuscript study, Yoshinao Sato, MD, PhD, from the Diagnostic Imaging Center at Japan’s Cancer Institute Hospital in Tokyo, and colleagues, and colleagues aimed to compare the utility of ringlike peripheral increased iodine concentration and conventional findings for differentiating primary lung cancers from pulmonary metastases on dual-energy CT (DECT).

The study included 93 patients (64 men, 29 women; median age, 70 years) who underwent resection of primary lung cancer (n=68) or pulmonary metastasis (n=25) corresponding with a solid lesion on preoperative contrast-enhanced DECT performed between April 2020 and March 2021. After constructing venous-phase 120-keV single-energy images, equilibrium-phase 66-keV virtual monoenergetic images, as well as iodine concentration maps, two radiologists independently assessed lesions for the following: spiculated margins, air bronchograms, rim enhancement, and thin ringlike peripheral high iodine concentration.